Health and Care Bill (HL Bill 71)

Part 1 continued    

14Z28 Transfer schemes in connection with integrated care boards

(1)NHS England may, in connection with the abolition of a clinical
commissioning group under section 14Z27, make a scheme for the
transfer of the group’s property, rights or liabilities to NHS England or
5an integrated care board.

(2)NHS England may, in connection with the establishment of an
integrated care board, make a scheme for the transfer of property,
rights or liabilities to the board from—

(a)NHS England,

(b)10an NHS trust established under section 25,
an NHS foundation trust, or

(d)a Special Health Authority established under section 28.

(3)NHS England may, in connection with the variation of the constitution
of an integrated care board or the abolition of an integrated care board,
15make a scheme for the transfer of the board’s property, rights or
liabilities to NHS England or an integrated care board.

(4)The reference in subsection (3) to the variation of the constitution of an
integrated care board is to its variation by order under section 14Z25 or
under provision included in its constitution by virtue of paragraph 14
20of Schedule 1B.

(5)NHS England must exercise its powers under subsection (1) or (3) so as
to ensure that—

(a)on the abolition of a clinical commissioning group whose area
coincides with that of an integrated care board, all of the
25group’s property, rights and liabilities (other than criminal
liabilities) are transferred to that board;

(b)on the abolition of a clinical commissioning group whose area
does not coincide with that of an integrated care board, all of the
group’s property, rights and liabilities (other than criminal
30liabilities) are transferred to one or more integrated care boards;

(c)on the abolition of an integrated care board, all of the board’s
liabilities (other than criminal liabilities) are transferred.

(6)The things that may be transferred under a transfer scheme include—

(a)property, rights and liabilities that could not otherwise be
35transferred;

(b)property acquired, and rights and liabilities arising, after the
making of the scheme;

(c)criminal liabilities.

(7)A transfer scheme may—

(a)40create rights, or impose liabilities, in relation to property or
rights transferred;

(b)make provision about the continuing effect of things done by,
on behalf of or in relation to the transferor in respect of anything
transferred;

(c)45make provision about the continuation of things (including
legal proceedings) in the process of being done by, on behalf of
or in relation to the transferor in respect of anything transferred;

(d)make provision for references to the transferor in an instrument
or other document in respect of anything transferred to be
treated as references to the transferee;

(e)make provision for the shared ownership or use of property;

(f)5make provision which is the same as or similar to the TUPE
regulations;

(g)make other consequential, supplementary, incidental or
transitional provision.

(8)A transfer scheme may provide—

(a)10for modifications by agreement;

(b)for modifications to have effect from the date when the original
scheme came into effect.

(9)In subsection (7)(f), “the TUPE regulations” means the Transfer of
Undertakings (Protection of Employment) Regulations 2006 (S.I. 2006/
15246).

(10)In this section—

(a)references to rights and liabilities include rights and liabilities
relating to a contract of employment;

(b)references to the transfer of property include the grant of a
20lease.

Constitution: publication

14Z29 Duty for integrated care board to publish constitution

Each integrated care board must publish its constitution (as varied
from time to time by order under section 14Z25 or under provision
25included in its constitution by virtue of paragraph 15 of Schedule 1B).

Conflicts of interest

14Z30 Register of interests and management of conflicts of interests

(1)Each integrated care board must maintain one or more registers of the
interests of—

(a)30members of the board,

(b)members of its committees or sub-committees, and

(c)its employees.

(2)Each integrated care board must publish the registers maintained
under subsection (1) or make arrangements to ensure that members of
35the public have access to the registers on request.

(3)Each integrated care board must make arrangements to ensure—

(a)that a person mentioned in subsection (1) declares any conflict
or potential conflict of interest that the person has in relation to
a decision to be made in the exercise of the commissioning
40functions of the integrated care board,

(b)that any such declaration is made as soon as practicable after the
person becomes aware of the conflict or potential conflict and,
in any event, within 28 days of the person becoming aware, and

(c)that any such declaration is included in the registers maintained
under subsection (1).

(4)Each integrated care board must make arrangements for managing
conflicts and potential conflicts of interest in such a way as to ensure
5that they do not, and do not appear to, affect the integrity of the board’s
decision-making processes.

(5)For the purposes of this section, the commissioning functions of an
integrated care board are the functions of the board in arranging for the
provision of services as part of the health service.”

(3)10In section 272 (orders, regulations, rules and directions), in subsection (1),
before paragraph (a) insert—

“(za)section 14Z25(2),”.

(4)Schedule 2 inserts into the National Health Service Act 2006 a new Schedule 1B
(integrated care boards: constitution etc) and contains a consequential
15amendment.

15 People for whom integrated care boards have responsibility

(1)The National Health Service Act 2006 is amended as follows.

(2)After section 14Z30 (inserted by section 14 of this Act) insert—

“People for whom integrated care board has responsibility

14Z31 20 People for whom integrated care board has responsibility

(1)NHS England must from time to time publish rules for determining the
group of people for whom each integrated care board has core
responsibility.

(2)The rules must ensure that the following are allocated to at least one
25group—

(a)everyone who is provided with NHS primary medical services,
and

(b)everyone who is usually resident in England and is not
provided with NHS primary medical services.

(3)30Regulations may create exceptions to subsection (2) in relation to
people of a prescribed description (which may include a description
framed by reference to the primary medical services with which the
people are provided).

(4)References in this Act to the group of people for whom an integrated
35care board has core responsibility are to be read in accordance with this
section.

(5)In this section, “NHS primary medical services” means services
provided by a person, other than NHS England or an integrated care
board, in pursuance of—

(a)40a general medical services contract to provide primary medical
services of a prescribed description,

(b)arrangements under section 83(2) for the provision of primary
medical services of a prescribed description, or

(c)section 92 arrangements for the provision of primary medical
services of a prescribed description.”

(3)In section 272 (orders, regulations, rules and directions)—

(a)in subsection (1), after paragraph (za) (inserted by section 14 of this Act)
5insert—

“(zb)section 14Z31(1),”;

(b)in subsection (6), after paragraph (zb) insert—

“(zba)regulations under section 14Z31(3),”.

(4)The Secretary of State may by regulations—

(a)10substitute the following section for section 14Z31 of the National
Health Service Act 2006 (as inserted by subsection (1) of this section)—

“14Z31 People for whom integrated care board has responsibility

(1)References in this Act to the group of people for whom an
integrated care board has core responsibility are to the people
15who usually reside in its area.

(2)Regulations may create exceptions to subsection (1) in relation
to people of a prescribed description.”,”

(b)repeal section 272(1)(zb) of that Act (as inserted by subsection (2) of this
section), and

(c)20amend section 272(6)(zba) of that Act (as inserted by subsection (2) of
this section), so as to substitute “14Z31(2)” for “14Z31(3)”.

Integrated care boards: functions

16 Commissioning hospital and other health services

For sections 3 and 3A of the National Health Service Act 2006 substitute—

“3 25Duties of integrated care boards as to commissioning certain health
services

(1)An integrated care board must arrange for the provision of the
following to such extent as it considers necessary to meet the
reasonable requirements of the people for whom it has responsibility—

(a)30hospital accommodation,

(b)other accommodation for the purpose of any service provided
under this Act,

(c)medical services other than primary medical services (for
primary medical services, see Part 4),

(d)35dental services other than primary dental services (for primary
dental services, see Part 5),

(e)ophthalmic services other than primary ophthalmic services
(for primary ophthalmic services, see Part 6),

(f)(f)nursing and ambulance services,

(g)40such other services or facilities for the care of pregnant women,
women who are breastfeeding and young children as the board
considers are appropriate as part of the health service,

(h)such other services or facilities for the prevention of illness, the
care of persons suffering from illness and the after-care of

persons who have suffered from illness as the board considers
are appropriate as part of the health service, and

(i)such other services or facilities as are required for the diagnosis
and treatment of illness.

(2)5For the purposes of this section an integrated care board has
responsibility for—

(a)the group of people for whom it has core responsibility (see
section 14Z31), and

(b)such other people as may be prescribed (whether generally or in
10relation to a prescribed service or facility).

(3)The duty imposed on an integrated care board by subsection (1) to
arrange for the provision of services or facilities does not apply to the
extent that—

(a)NHS England has a duty to arrange for their provision;

(b)15another integrated care board has a duty to arrange for their
provision by virtue of subsection (2)(b).

(4)In exercising its functions under this section, an integrated care board
must act consistently with—

(a)the discharge by the Secretary of State and NHS England of
20their duty under section 1(1) (duty to promote a comprehensive
health service), and

(b)the objectives and requirements for the time being specified in
the mandate published under section 13A.

3A Power of integrated care boards to commission certain health services

(1)25Each integrated care board may arrange for the provision of such
services or facilities as it considers appropriate for the purposes of the
health service that relate to securing improvement—

(a)in the physical and mental health of the people for whom it has
responsibility, or

(b)30in the prevention, diagnosis and treatment of illness in those
people.

(2)For the purposes of this section an integrated care board has
responsibility for—

(a)the group of people for whom it has core responsibility (see
35section 14Z31), and

(b)such other people as may be prescribed (whether generally or in
relation to a prescribed service or facility).

(3)An integrated care board may not arrange for the provision of a service
or facility under subsection (1) if NHS England has a duty to arrange
40for its provision by virtue of section 3B or 4.

(4)In exercising its functions under this section, an integrated care board
must act consistently with—

(a)the discharge by the Secretary of State and NHS England of
their duty under section 1(1) (duty to promote a comprehensive
45health service), and

(b)the objectives and requirements for the time being specified in
the mandate published under section 13A.”

17 Commissioning primary care services etc

Schedule 3 confers functions on integrated care boards in relation to primary
care services and contains other amendments relating to primary care services.

18 Transfer schemes in connection with transfer of primary care functions

(1)5NHS England may, in connection with the amendments made by Schedule 3,
make one or more schemes for the transfer of its property, rights and liabilities
to an integrated care board.

(2)The things that may be transferred under a transfer scheme include—

(a)property, rights and liabilities that could not otherwise be transferred;

(b)10property acquired, and rights and liabilities arising, after the making of
the scheme;

(c)criminal liabilities.

(3)A transfer scheme may—

(a)create rights, or impose liabilities, in relation to property or rights
15transferred;

(b)make provision about the continuing effect of things done by, on behalf
of or in relation to the transferor in respect of anything transferred;

(c)make provision about the continuation of things (including legal
proceedings) in the process of being done by, on behalf of or in relation
20to the transferor in respect of anything transferred;

(d)make provision for references to the transferor in an instrument or
other document in respect of anything transferred to be treated as
references to the transferee;

(e)make provision for the shared ownership or use of property;

(f)25make provision which is the same as or similar to the TUPE regulations;

(g)make other consequential, supplementary, incidental or transitional
provision.

(4)A transfer scheme may provide—

(a)for modifications by agreement;

(b)30for modifications to have effect from the date when the original scheme
came into effect.

(5)In subsection (3)(f), “the TUPE regulations” means the Transfer of
Undertakings (Protection of Employment) Regulations 2006 (S.I. 2006/246).

(6)For the purposes of this section—

(a)35references to rights and liabilities include rights and liabilities relating
to a contract of employment;
references to the transfer of property include the grant of a lease.

19 Commissioning arrangements: conferral of discretions

In section 12ZA of the National Health Service Act 2006 (commissioning
40arrangements by NHS England and integrated care boards), after
subsection (2) insert—

“(2A)The arrangements may confer discretions on a person with whom they
are made in relation to anything to be provided under the
arrangements.”

20 General functions

(1)The National Health Service Act 2006 is amended as follows.

(2)After section 14Z31 (inserted by section 15 of this Act) insert—

“General duties of integrated care boards

14Z32 5 Duty to promote NHS Constitution

(1)Each integrated care board must, in the exercise of its functions—

(a)act with a view to securing that health services are provided in
a way which promotes the NHS Constitution, and

(b)promote awareness of the NHS Constitution among patients,
10staff and members of the public.

(2)In this section, “patients” and “staff” have the same meaning as in
Chapter 1 of Part 1 of the Health Act 2009 (see section 3(7) of that Act).

14Z33 Duty as to effectiveness, efficiency etc

Each integrated care board must exercise its functions effectively,
15efficiently and economically.

14Z34 Duty as to improvement in quality of services

(1)Each integrated care board must exercise its functions with a view to
securing continuous improvement in the quality of services provided
to individuals for or in connection with the prevention, diagnosis or
20treatment of illness.

(2)In discharging its duty under subsection (1), an integrated care board
must, in particular, act with a view to securing continuous
improvement in the outcomes that are achieved from the provision of
the services.

(3)25The outcomes relevant for the purposes of subsection (2) include, in
particular, outcomes which show—

(a)the effectiveness of the services,

(b)the safety of the services, and

(c)the quality of the experience undergone by patients.

14Z35 30 Duties as to reducing inequalities

Each integrated care board must, in the exercise of its functions, have
regard to the need to—

(a)reduce inequalities between patients with respect to their ability
to access health services, and

(b)35reduce inequalities between patients with respect to the
outcomes achieved for them by the provision of health services.

14Z36 Duty to promote involvement of each patient

Each integrated care board must, in the exercise of its functions,
promote the involvement of patients, and their carers and
40representatives (if any), in decisions which relate to—

(a)the prevention or diagnosis of illness in the patients, or

(b)their care or treatment.

14Z37 Duty as to patient choice

Each integrated care board must, in the exercise of its functions, act
with a view to enabling patients to make choices with respect to aspects
of health services provided to them.

14Z38 5 Duty to obtain appropriate advice

Each integrated care board must obtain advice appropriate for enabling
it effectively to discharge its functions from persons who (taken
together) have a broad range of professional expertise in—

(a)the prevention, diagnosis or treatment of illness, and

(b)10the protection or improvement of public health.

14Z39 Duty to promote innovation

Each integrated care board must, in the exercise of its functions,
promote innovation in the provision of health services (including
innovation in the arrangements made for their provision).

14Z40 15 Duty in respect of research

Each integrated care board must, in the exercise of its functions,
promote—

(a)research on matters relevant to the health service, and

(b)the use in the health service of evidence obtained from research.

14Z41 20 Duty to promote education and training

Each integrated care board must, in exercising its functions, have
regard to the need to promote education and training for the persons
mentioned in section 1F(1) so as to assist the Secretary of State and
Health Education England in the discharge of the duty under that
25section.

14Z42 Duty to promote integration

(1)Each integrated care board must exercise its functions with a view to
securing that health services are provided in an integrated way where
it considers that this would—

(a)30improve the quality of those services (including the outcomes
that are achieved from their provision),

(b)reduce inequalities between persons with respect to their ability
to access those services, or

(c)reduce inequalities between persons with respect to the
35outcomes achieved for them by the provision of those services.

(2)Each integrated care board must exercise its functions with a view to
securing that the provision of health services is integrated with the
provision of health-related services or social care services where it
considers that this would—

(a)40improve the quality of the health services (including the
outcomes that are achieved from the provision of those
services),

(b)reduce inequalities between persons with respect to their ability
to access those services, or

(c)reduce inequalities between persons with respect to the
outcomes achieved for them by the provision of those services.

(3)In this section—

• “health-related services” means services that may have an effect
  5on the health of individuals but are not health services or social
  care services;

• “social care services” means services that are provided in
  pursuance of the social services functions of local authorities
  (within the meaning of the Local Authority Social Services Act
  101970 or for the purposes of the Social Services and Well-being
  (Wales) Act 2014).

(4)For the purposes of this section, the provision of housing
accommodation is a health-related service.

14Z43 Duty to have regard to wider effect of decisions

(1)15In making a decision about the exercise of its functions, an integrated
care board must have regard to all likely effects of the decision in
relation to—

(a)the health and well-being of the people of England;

(b)the quality of services provided to individuals—

(i)20by relevant bodies, or

(ii)in pursuance of arrangements made by relevant bodies,

for or in connection with the prevention, diagnosis or treatment
of illness, as part of the health service in England;

(c)efficiency and sustainability in relation to the use of resources
25by relevant bodies for the purposes of the health service in
England.

(2)The reference in subsection (1) to a decision does not include a reference
to a decision about the services to be provided to a particular individual
for or in connection with the prevention, diagnosis or treatment of
30illness.

(3)In discharging the duty under this section, integrated care boards must
have regard to guidance published by NHS England under section
13NB.

(4)In this section “relevant bodies” means—

(a)35NHS England,

(b)integrated care boards,

(c)NHS trusts established under section 25, and

(d)NHS foundation trusts.

Involvement of the public

14Z44 40 Public involvement and consultation by integrated care boards

(1)This section applies in relation to any health services which are, or are
to be, provided pursuant to arrangements made by an integrated care
board in the exercise of its functions (“commissioning arrangements”).

(2)The integrated care board must make arrangements to secure that
45individuals to whom the services are being or may be provided, and

their carers and representatives (if any), are involved (whether by being
consulted or provided with information or in other ways)—

(a)in the planning of the commissioning arrangements by the
integrated care board,
5in the development and consideration of proposals by the
integrated care board for changes in the commissioning
arrangements where the implementation of the proposals
would have an impact on—

(i)the manner in which the services are delivered to the
10individuals (at the point when the service is received by
them), or

(ii)the range of health services available to them, and

in decisions of the integrated care board affecting the operation
of the commissioning arrangements where the implementation
15of the decisions would (if made) have such an impact.

(3)This section does not require an integrated care board to make
arrangements in relation to matters to which a trust special
administrator’s draft or final report under section 65F or 65I relates
before—

(a)20in a case where the administrator’s report relates to an NHS
trust, NHS England and the Secretary of State have made their
decisions under section 65K(1) and (2), or

(b)in a case where the administrator’s report relates to an NHS
foundation trust, the Secretary of State is satisfied as mentioned
25in section 65KB(1) or 65KD(1) or makes a decision under section
65KD(9).

Joint exercise of functions with Local Health Boards

14Z45 Joint exercise of functions with Local Health Boards

(1)Regulations may provide for any prescribed functions of an integrated
30care board to be exercised jointly with a Local Health Board.

(2)The regulations may permit or require any functions that are
exercisable jointly by an integrated care board and a Local Health
Board by virtue of the regulations to be exercised by a joint committee
of those bodies.

(3)35Arrangements made by virtue of this section do not affect the liability
of an integrated care board for the exercise of any of its functions.

Additional powers of integrated care boards

14Z46 Raising additional income

(1)An integrated care board has power to do anything specified in section
407(2)(a), (b) and (e) to (h) of the Health and Medicines Act 1988
(provision of goods etc) for the purpose of making additional income
available for improving the health service.

(2)An integrated care board may exercise a power conferred by subsection
(1) only to the extent that its exercise does not to any significant extent
45interfere with the exercise by the board of its other functions.